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PubMedDate not supplied

VOR gain and phase in active head rotation tests of normal subjects and patients with peripheral labyrinthine lesions.

The gain and phase of the vestibulo-ocular reflex (VOR) were studied by active head rotation tests in normal subjects and in patients with unilateral or bilateral lesions of vestibular function. The examination was performed under two conditions: alert-in-dark and with spatially-fixed target. The results were evaluated using a simplified model of vestibular response. Under alert-in-dark condition, the VOR grain and phase deficits were observed on rotation to the affected side in patients with unilateral lesions and bilaterally in patients with bilateral lesions. Under spatially-fixed-target condition, these patients showed a decrease in gain at higher frequencies but no phase lag was observed. The principally new advantage was that not only VOR gain but also VOR phase could be quantified using this active head rotation test. Therefore, for diagnosing VOR dysfunction, this active head rotation test is more useful than the active head rotation tests previously reported.

Adult↗
PubMed2002

Vibration-induced shift of the subjective visual horizontal: a sign of unilateral vestibular deficit.

BACKGROUND: Vibration to the head or neck excites vestibular and neck muscle spindle afferents. Can such vibrations improve the sensitivity of the subjective visual horizontal (SVH) test to chronic unilateral deficit of the vestibular system? DESIGN: Controlled experimental study. SETTING: Tertiary referral center. PATIENTS AND CONTROLS: Thirteen healthy subjects and 23 patients with chronic unilateral vestibular deficits after vestibular neurectomy or neurolabyrinthitis. Results of head-impulse test showed unilateral loss of function of all 3 semicircular canals in 14 patients and loss of anterior and lateral semicircular canals in 9 patients. INTERVENTION: Unilateral vibration (92 Hz; 0.6-mm amplitude) applied to sternocleidomastoid muscle (SCM) or mastoid bone. MAIN OUTCOME MEASURE: Results of SVH test (in degrees). RESULTS: Without vibration, 13 of 23 patients and all healthy subjects had SVH of less than 3 degrees (sensitivity, 43%; specificity, 100%). During vibration to the ipsilesional SCM, SVH increased to greater than 3 degrees in 21 of 23 patients but in only 1 of 13 healthy subjects (sensitivity, 91%; specificity, 92%). The patient group had significantly greater SVH shifts to the ipsilesional side than did healthy subjects in response to SCM and mastoid bone vibration on either side. The SVH shift during vibration to the ipsilesional SCM was significantly greater than that during vibration to the contralesional muscle (P<.001) or to the mastoid bone on either side (P<.05). The vibration-induced SVH shift was significantly greater in those patients with loss of 3 semicircular canals than in those with loss of 2 (P<.01). CONCLUSIONS: The sensitivity of the SVH test to chronic unilateral vestibular deficits can be improved by applying vibration to the SCM. The magnitude of vibratory SVH shift is related to the extent of unilateral deficit of the otolithic organs, vertical canals, or both.

Adult↗
PubMed1994

[Unterberger's test not useful in testing of vesitibular function].

OBJECTIVE: Quantification of the stepping test in routine neurological examination. SETTING: University Hospital Groningen, the Netherlands. DESIGN: Prospective, controlled study. METHODS: The stepping test was assessed in 41 healthy subjects, in 7 subjects with artificially induced vertigo and in 83 patients with disturbances of gait or equilibrium resulting from different affections of the central nervous system. Displacement and rotation to the right or the left side were measured. The different groups were then compared with each other. RESULTS: We found a great inter- and intra-individual variation in direction and width of rotation and in displacement. The results of the test are not influenced by right(+)-or left(-)-handedness or by dominance of the right or the left leg. CONCLUSION: The current test does not appear to be useful for detection of abnormalities in the vestibular system or for distinguishing normal individuals from patients.

Caloric Tests↗
PubMed1994

Vestibular compensation.

Regulation of the human equilibrium differs from the other, mostly linear, human senses. It consists of a multitude of receptors and an interrelated network that is necessary for data processing as well as for regulatory processes. Thus, the human equilibrium system represents a mixture of hardware and related software interactions. The input is also named the "equilibrium tetrade" (1-3), and comprises vision, vestibular inertia acceleration perception, proprioception and hearing. In the case of various types of lesion, one has to deal with a variety of morphological as well as mostly functional reparations. Amongst others these consist of restitution, adaptation, suppression, habituation and compensation. In order to objectively investigate the type of ongoing compensatory reparation within the complex network functions of the equilibrium system, we need to apply the so-called complex vestibular equilibrium tests. These allow us to quantitatively check for the response outputs after varying stimulus loadings, as well as after spatial or temporal stimulus interferences. For testing the equilibrium system under the condition of varying stimulus intensity impacts, the vestibular stimulus response intensity comparison test (VSRIC) is applied (4-6). Spatial stimulus interference between the ocular and the vestibular system is checked by means of the calorisation pendulum interference test (CPIT) (1, 2, 5, 7-9). In the case of temporal stimulus interference testing it is assumed that a memory copy of earlier stimuli influences successive reactions. Thus phenomena such as learning or habituation can be induced. Temporal stimulus interference is tested by means of the caloric adaptation cyclogram (CAC) (2-5, 10, 11).

Adaptation, Physiological↗
PubMedDate not supplied

[Vestibular migraine].

Among varieties of migraine characteristic of liquidators of effects of the Chernobyl catastrophy and ChNPP personnel migraine with a manifest vestibular component holds a prominent place. As many as 803 middle-aged patients, average age (39.6 +/- 11.8) years, were examined. Among these were the ChNPP personnel, liquidators, and migrators from Pripyat, who had received low doses of radiation to 0.5 rem. Used in the examination were questionnaire survey (HOACK), vestibular tests (Uemura, Fukuda, etc.), nistagmography, cardiography with Takagasi loading tests, multisensory evoked potentials. Virtually all examinees demonstrated disturbances in the vestibular function. Of these, 92.4 percent of subjects had headache complaints. In 35 percent of the examinees, pain was of a typical migranous character. Additional signs included asthenization, vegetative symptomatology, vestibulocardial syndrome, emotional derangements. The histamine blocking agents dimenhydrinate and betaserk proved to be the most effective treatment options in the above patient population.

Adult↗
PubMed1990

[Pressure wave-induced damage of the vestibular apparatus in guinea pigs. A transmission electron microscopic study].

Guinea pigs were exposed to pressure wave with a peak pressure value of 175.3dB (SPL). Vestibular test and stereoscopic and TEM observations were performed after the exposure. Vestibular function was normal. Within 48 hours of exposure, slight mechanical injuries of the sensory cells in both the creista and macula were observed, such as displacement of the otolithic membrane, distortion and fusion of cilia and protrusion of the cytoplasm. On the 7th and 14th day, these changes became less marked, but a few cells showed swelling of mitochondria and nerve chalice and abnormalities of afferent nerve terminals, which were supposed to be resulted from metabolic disorders. The significance of these changes was discussed.

Animals↗
PubMed1998

Computerized dynamic visual acuity test in the assessment of vestibular deficits.

OBJECTIVE: The study was designed to measure dynamic visual acuity (DVA) during head movement as an assessment of the functional impact of vestibular deficits. STUDY DESIGN: The study design was a prospective, clinical study. SETTING: The study was performed in a tertiary, ambulatory referral center. PATIENTS: Forty-two normal subjects, 29 patients with unilateral vestibular loss, and 26 patients with bilateral vestibular hypofunction who were 19-87 years of age were examined. INTERVENTION: Diagnostic intervention was performed. MAIN OUTCOME MEASURE: Main outcome measures included the reliability, sensitivity, and specificity of a computerized test that measures visual acuity during head movement in normal subjects and in patients with vestibular deficits. RESULTS: The computerized DVA test was reliable in both normal subjects (intraclass correlation coefficient [ICC] r=0.87) and in patients with vestibular deficits (ICC r=0.83). The sensitivity of the DVA test was 94.5% and the specificity was 95.2%. The positive predictive value (individuals who test positive on the DVA test who will have a vestibular deficit) was 96.3%. The negative predictive value (individuals who test negative on the DVA test who will not have a vestibular deficit) was 93%. CONCLUSIONS: The computerized DVA test is reliable and is able to distinguish among normal subjects and patients with vestibular deficits.

Adult↗
PubMed1997

Selective vestibular damage in neurosarcoidosis.

We report a patient with neurosarcoidosis who developed bilateral benign paroxysmal positional vertigo (BPPV) of the posterior canals, deafness, and absent responses to conventional caloric and rotational vestibular testing. Additional rotation in the planes of the vertical semicircular canals revealed relative sparing of vertical canal function. This vertical-horizontal canal dissociation explains the presence of BPPV and suggests that the vestibular damage in this patient is secondary to a vasculitic neuropathy.

Adult↗
PubMed1979

Impulsive and sinusoidal rotatory testing: a comparison with results of caloric testing.

The usefulness of rotatory testing (impulsive and sinusoidal) as an indicator of impaired horizontal semicircular canal function was evaluated in 63 patients with unilateral and bilateral decreased caloric responses. The rotatory stimuli were precisely controlled over a large magnitude range and EOG recorded nystagmus responses were quantified using digital analysis techniques. Rotatory testing was consistently abnormal in patients with complete unilateral caloric paralyses but was normal in over one-half of the patients with significant but less than complete unilateral caloric paralyses. The difference in maximum slow component velocity (SVMX) of induced nystagmus after the largest rotatory stimuli was the best indicator of unilateral impaired function. The patients with bilateral decreased caloric responses demonstrated three categories of rotatory response: 1. normal at all magnitudes of stimulation, 2. decreased but present after large magnitude stimuli, and 3. absent responses. It is concluded that although rotatory testing cannot replace caloric testing it can provide useful clinical information particularly in patients suspected of having bilateral vestibular disease.

Caloric Tests↗
PubMed2004

Horizontal vestibulo-ocular reflex dynamics in acute vestibular neuritis and viral labyrinthitis: evidence of otolith-canal interaction.

OBJECTIVE: To evaluate the dynamic properties of the horizontal vestibulo-ocular reflex (h-VOR) in the acute stage of two common labyrinthine diseases that provoke severe attacks of vertigo with spontaneous nystagmus: vestibular neuritis (vestibular loss alone) and viral labyrinthitis (cochleovestibular loss). MATERIAL AND METHODS: Sixty-three patients were investigated: 42 were diagnosed with vestibular neuritis and 21 with viral labyrinthitis. The h-VOR function was evaluated by conventional caloric and impulsive testing. A simplified model of vestibular function was used to analyze the vestibulo-ocular response to rotational stimulation. RESULTS: The results showed a significant difference in h-VOR characteristics between the two pathologies. Patients with vestibular neuritis exhibited a strong horizontal semicircular canal deficit, but no h-VOR asymmetry between the two rotational directions. In contrast, patients with viral labyrinthitis demonstrated moderate canal paresis and a marked h-VOR deficit in rotation toward the affected ear. CONCLUSION: These findings support the hypothesis that the h-VOR dynamic asymmetry that occurs after an acute unilateral inner ear lesion is not due to canal dysfunction alone, but involves complex adaptive changes in the central VOR that may implicate the otolith system. Based on histopathologic and clinical differences in the two pathologies reported in the literature, we postulate that this otolith-canal interaction is mainly linked to the loss of saccular function.

Adolescent↗
PubMed2000

Balance function testing: a rational approach.

Recent advances in the area of balance function testing have left clinicians with a wide variety of diagnostic tests that provide insights into the function of the balance system. Laboratory tests used to evaluate the balance system include electronystagmography, rotational chair, and dynamic posturography. This article summarizes the currently available balance function testing protocols. A cost-effective and rational protocol for the application of these tests is provided.

Caloric Tests↗
PubMed1989

Evaluation of balance function in peripheral vestibular disorders.

The functional influence upon overall balance function induced by a peripheral vestibular disturbance is evaluated by positioning, rotatory and posturographic testing. The information does not contribute to the diagnostic labelling of a patient (as e.g. Ménière's disease, etc), but it is of primary importance in the determination of a logical and adequate treatment and so for rehabilitation treatment. Some important items are reviewed.

Electronystagmography↗